Assessment of the ECG T-Wave in Patients With Subarachnoid Hemorrhage. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Komatsuzaki, Makoto; Takasusuki, Toshifumi; Kimura, Yoshiyuki; Yamaguchi, Shigeki
• Is Part Of: Journal of neurosurgical anesthesiology. Volume 33:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: Hunt and Hess grade -- Glasgow outcome scale -- QT dispersion -- QT interval -- subarachnoid hemorrhage -- Tpeak-tend interval -- Tpeak-tend/QT ratio; Anesthesia in neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; 617.96748
• DOI: 10.1097/ANA.0000000000000624
• Languages: English
• ISSNs: 0898-4921

Abstract

Abstract : Background: Prolongation of the interval from the peak to the end of the T wave (Tp-Te) on a 12-lead electrocardiogram (ECG) is associated with ventricular arrhythmias. The aim of this study was to clarify associations between Tp-Te, Tp-Te/QT, and Tp-Te/rate-corrected QT (QTc) with clinical severity of subarachnoid hemorrhage (SAH) and clinical outcomes. Methods: This retrospective study included 222 patients with acute SAH (group S) and 306 patients with unruptured cerebral aneurysms (group U). Tp-Te, Tp-Te/QT, and Tp-Te/QTc were manually measured in standard 12-lead ECG recordings on admission and comparisons made between patients in groups S and U. The relationships of these ECG parameters with Hunt and Hess grade and Glasgow outcome scale were analyzed using multiple logistic regression analysis after adjustment for confounding factors. Results: Tp-Te, Tp-Te/QT, and Tp-Te/QTc were significantly greater in group S than in group U (group S: 109±30, 0.26±0.07, and 0.24±0.06 ms; group U: 84±12, 0.22±0.03, and 0.21±0.03 ms, respectively; P < 0.0001). In addition, in the multiple logistic regression analyses these variables were positively correlated with the Hunt and Hess grade (Tp-Te odds ratio [95% confidence interval], 2.414 [1.375-4.238], P =0.002; Tp-Te/QT, 1.886 [1.085-3.277], P = 0.024; Tp-Te/QTc, 1.873 [1.07-3.278], P =0.028, and negatively correlated with Glasgow outcome scale Tp-Te odds ratio [95% confidence interval], 4.168 [2.409-7.209], P <0.001; Tp-Te/QT, 2.434 [1.413-4.192], P =0.001; Tp-Te/QTc 2.953 [1.703-5.123], P <0.001). Conclusions: Tp-Te, Tp-Te/QT, and Tp-Te/QTc are associated with disease severity and clinical outcome in patients with SAH. Abstract : Supplemental Digital Content is available in the text.